Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. BRIAN C FULLER, M.D.
DeactivatedDR. BRIAN C FULLER, M.D. is a Sports Medicine (Orthopaedic) healthcare provider located in CARROLLTON, Texas. NPI 1396972386 is deactivated in the NPPES registry. Verify at CMS.
Sports Medicine (Orthopaedic) · CARROLLTON, TX
This NPI has been deactivated.
The record was deactivated on August 21, 2019.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1396972386
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 17, 2009 (10.177595628415 yrs)
- Last Updated
- Jun 29, 2020
- Deactivated
- Aug 21, 2019
- Licenses
-
25870 (NE)036144916 (IL)R8564 (TX)
Practice Information
- Address
-
4780 N JOSEY LNCARROLLTON, TX, 750104615Browse TX providers · Browse ZIP 75010
- Phone
- 9724921334
- Fax
- 9724927909
- Primary Specialty
-
Sports Medicine (Orthopaedic)
207XS0114X
- Additional Specialty
- Sports Medicine (Orthopaedic)
- Additional Specialty
- Sports Medicine (Orthopaedic)
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.